This study evaluates the effect of rheumatoid arthritis of the forefoot on gait, and prospectively evaluates the effect of an established surgical technique on gait and function. While resection arthroplasty of the metatarsal heads is the standard surgical treatment for forefoot arthritis in rheumatoid arthritis (RA), there is little data available currently on the functional or biomechanical outcome. Using a sophisticated gait laboratory, we measure stride parameters and kinematic and kinetic variables of the stance phase of gait pre and post surgery, in addition to measures of pain and functional mobility. Subjects are evaluated before and three and twelve months post surgery. This study will provide objective data needed to evaluate the role of surgery in the management of forefoot arthritis in RA, in addition to information on how pain and alterations in the structural integrity of the foot influences gait. To date, 28 patients have been evaluated before possible surgery, and 8 entered into the post surgery phase of the study. Important information on the effects of forefoot arthritis has been obtained and to date 4 abstracts have been submitted or presented. Two articles detailing preoperative findings are being prepared for submission to scientific journals. Recruitment continues.
